2. -Melinda,a 17-years old girl, received a heart transplantation six months ago -underwent immunosupression therapy all the time. -Be sensitive to penicillin,bee stings and peanut. Case:

4. Symptoms: ●large hives on her skin, angioedema( 血管 性水肿 ) sets in ●Within seconds, she is wheezing and having difficulty breathing ●Spasm

5. penicilin allergy! 1.RIST test indicate the increase of lgE concentration in her serum. 2. Strongly positive lgE-specific Ab to penicillin were present on RAST test(allergic history: to penicillin, bee stings, and peanuts ) 3. CT test,myocardium biopsy,blood test exclude heart failure.

6. CT-----brain injury Cardiac biopsy-----rejection reaction Blood test -----infection MRI----- stroke ; aneurysmMRI Epinephrine can cure allergies.

7. Belong to type Ⅰ hypersensitivity A life-threatening allergic response that occurs within seconds to minutes of exposure to an antigen. early phase reaction, mainly caused by histamine Systemic anaphylaxis:

8. Mechanism of type I hypersensitivity 1. Allergy-induced period 2. allergy-stimulated period 3. effect period

9. Type Ⅰ hypersensitivity Type Ⅰ hypersensitivity

10. Therapy for allergy 1. Eliminate allergen (penicillin):stop using drug tie tourniquet on near heart direct. 2. reducing the quantity of IgE present :use anti-lgE antibody to prevent IgE binds to Fc  R I on mast cells and basophils. 超级连接prevent IgE binds to Fc  R 3. Epinephrine 4. Prevent mast cell degranulation Ca influx inhibitor (chromolyn sodium) Phosphodiesterase (theophylline)

11. anti-lgE antibody Mast cell anti-lgE antibody

12. Epinephrine ： first choice! Mechanism: α receptor excitation: 收缩血管，血压升高， 保证重要脏器血液供应 β receptor excitation :Bronchodialat cAMP excitation :inhibit the release of mediators such as histamine.

16. plasma exchange

19. Find tick!!!